Commentary Abortion

Stigma, Shame, and Sexuality: A Reflection on Abortion

Stigma Shame and Sexuality Series

"The one that has an abortion is treated as…as bad, as a killer and…the other one is…is a good woman, she has a good heart, she loves children.” Sound familiar? Let’s face it: individuals who have had abortions or provide them are too often labeled, discriminated against and dehumanized.

This post is by Leila Hessini, and is part of Tsk Tsk: Stigma, Shame, and Sexuality, a series hosted by Gender Across Borders and cross-posted with Rewire in partnership with Ipas.

“The one that has an abortion is treated as…as bad, as a killer and…the other one is…is a good woman, she has a good heart, she loves children.” 

Sound familiar? The quote comes from a woman from the Copperbelt Province in Zambia during focus group interviews with Ipas, but it could be anywhere in the world. Let’s face it: individuals who have had abortions or provide them  are too often labeled, discriminated against and dehumanized.

This stigma surrounding abortion and anyone associated with it — women, providers, pharmacists and advocates — contributes toits social, medical and legal marginalization. And this marginalization can keep women from getting the health care they need.

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Abortion stigma is never just about abortion but plays out and attaches to different social issues and debates.  In the United States, abortion has become a lynchpin in our political debates and cultural wars – and the sentiment has spread to other countries. Ipas’s research in Zambia shows that women in certain communities who terminate their pregnancies are forced to go through a public cleansing process as a form of punishment for not  carrying a pregnancy to term.

“In a village setting, when a girl aborts she is supposed to be confined in a house for at least one month. She is also not allowed to touch certain things in the house or go to the stream to fetch for water as well because it is believed that she may cause people to get sick because of the spirit of abortion she bears. The headman would then assign people to go talk to this girl that she needs to be cleansed first before she can begin to mix with people again because she may bring some diseases on people.”

Abortion stigma is difficult to isolate because it is produced and reproduced across different levels, including individual, community, organizational and legal, and is played out through private and public discourse, including the media.  Women who need abortions face stigma and may even perpetuate it, as do providers of abortion services.  Entire communities have developed ways of separating, sterotyping and discriminating against women who need abortions.  Legal frameworks create categories of “acceptable” and “unacceptable” abortions and reward privilege to those women who obtain early abortions.  And abortions have been separated from comprehensive reproductive health-care services and from insurance programs, as well as totally dissociated from family planning.

Our current research shows that abortion stigma translates into internalized stigma, fear of disclosure and shame, difficulty finding information and services, and fear of the health system.  Stigma creates barriers to open and frank discussion about abortion and to women using services.  It leads to the  notion that abortions are rare, when they are not.   The cost of ignoring stigma and not finding strategies to address it is potentially huge—even a matter of life and death. In many of the countires where Ipas works in the global south, when women feel shame about abortion and can’t access accurate information, they often delay care or turn to untrained, unsafe providers, increasing the likelihood for complications and injuries, even death.

To better understand the manifestations of abortion stigma, Ipas conducted focus group interviews in Ghana and Zambia.  Stigma is manifested in different ways – some of which we anticipated in terms of the labeling but others we didn’t.  In Ghana and Zambia, for example, interviewees illustrated how abortion stigma is acted out the community level and how it influences attitudes toward women, as well as providers.

While abortions are quite common in both countries, labeling and stereotyping of women who need abortions, and assumptions about their sexual lives, surfaced in various ways:

 “Women who have abortions are prostitutes. She is just a nuisance, a whore who has a devil heart.” (married woman, Zambia)

“A woman who has an abortion probably had sex with lots of men. She doesn’t even know who the father is.” (single woman, Zambia)

Stigma fuels the humiliation and exclusion of women by their communities. In some communities women who abort can be excluded from community life.

 “We can eat and do other things together but when she is going somewhere we will not go with her,” said a Ghanaian participant about a woman who had an abortion.

Young women, and those who are unmarried are particularly vulnerable to scrutiny.

“When students know that another female student has induced an abortion, the students, especially the boys will organize a funeral ceremony for the aborted child. They will make a coffin for that child, organize a mourning ceremony during which they will cry, roll on the ground just to humiliate the girl. Girls are not always left out in this practice. Once the boys start, the girls too follow,” reported an interviewee in Lusaka, Zambia.

These responses have helped us to identify root causes of abortion stigma and to better understand social norms related to abortion, however much more needs to be done.  While we know that stigma exists, we need more information, analysis and data to understand it quantitatively and qualitatively and develop interventions to reduce it. This process will also help us understand our own role in creating and perpetuating it. The pro-choice community has even played a role: when we legitimize some abortions—early versus late or those that don’t need public funding versus those that do—we collectively stigmatize abortion.

While abortion stigma may seem inherent or insurmountable, in fact it is not.  This, perhaps, is the most empowering thing we can understand as advocates.   Abortion stigma is a social construct used to control women and abortion providers, and it’s a way that we punish women who deviate from social norms for what a woman should be. One of the first steps is to recognize it, own it and discuss it. And then let’s deconstruct what we’ve learned, what people believe to be true and create something different.

This series of blogs is an important step forward in that direction. We’d like to thank our partners Gender Across Borders and Rewire for spondering the series and fostering a place for dialogue, and the many contributors who shared their stories with us to make this discussion possible. Together let’s aspire toward a world where the rights of all women and health professional are upheld, fully and without exception.

Leila Hessini is Director of Community Engagement and Mobilization at Ipas and Board Chair of the Global Fund for Women. Leila has worked to oppose the control and exploitation of women’s bodies through sexuality, reproduction and labor for 20 years. Of Algerian descent, Leila has lived and worked extensively with women’s networks and community-based organizations in Europe, Africa and the United States. This post is adapted from an article appearing in the Fall 2011 issue of Because, the Ipas magazine that connects U.S. readers to women around the world, highlighting reproductive health and rights and making connections between U.S. policy and global health. For a free subscription to Becauseclick here.

News Politics

Democratic Party Platform: Repeal Bans on Federal Funding for Abortion Care

Ally Boguhn

When asked this month about the platform’s opposition to Hyde, Hillary Clinton’s running mate Sen. Tim Kaine (D-VA) said that he had not “been informed of that” change to the platform though he has “traditionally been a supporter of the Hyde Amendment.”

Democrats voted on their party platform Monday, codifying for the first time the party’s stated commitment to repealing restrictions on federal funding for abortion care.

The platform includes a call to repeal the Hyde Amendment, an appropriations ban on federal funding for abortion reimplemented on a yearly basis. The amendment disproportionately affects people of color and those with low incomes.

“We believe unequivocally, like the majority of Americans, that every woman should have access to quality reproductive health care services, including safe and legal abortion—regardless of where she lives, how much money she makes, or how she is insured,” states the Democratic Party platform. “We will continue to oppose—and seek to overturn—federal and state laws and policies that impede a woman’s access to abortion, including by repealing the Hyde Amendment.”

The platform also calls for an end to the Helms Amendment, which ensures that “no foreign assistance funds may be used to pay for the performance of abortion as a method of family planning.”

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Though Helms allows funding for abortion care in cases of rape, incest, and life endangerment, the Obama administration has failed to enforce those guarantees.

Despite the platform’s opposition to the restrictions on abortion care funding, it makes no mention of how the anti-choice measures would be rolled back.

Both presumptive Democratic nominee Hillary Clinton and Sen. Bernie Sanders (I-VT) have promised to address Hyde and Helms if elected. Clinton has said she would “fix the Helms Amendment.”

Speaking at the Iowa Brown and Black Presidential Forum in January, Clinton said that the Hyde Amendment “is just hard to justify because … certainly the full range of reproductive health rights that women should have includes access to safe and legal abortion.” In 2008, Clinton’s campaign told Rewire that she “does not support the Hyde amendment.”

When asked this month about the platform’s opposition to Hyde, Clinton’s running mate Sen. Tim Kaine (D-VA) said in an interview with the Weekly Standard that he had not “been informed of that” change to the platform though he has “traditionally been a supporter of the Hyde amendment.”

“The Hyde amendment and Helms amendment have prevented countless low-income women from being able to make their own decisions about health, family, and future,” NARAL President Ilyse Hogue said in a statement, addressing an early draft of the platform. “These amendments have ensured that a woman’s right to a safe and legal abortion is a right that’s easier to access if you have the resources to afford it. That’s wrong and stands directly in contrast with the Democratic Party’s principles, and we applaud the Party for reaffirming this in the platform.”

News Law and Policy

Texas Lawmaker’s ‘Coerced Abortion’ Campaign ‘Wildly Divorced From Reality’

Teddy Wilson

Anti-choice groups and lawmakers in Texas are charging that coerced abortion has reached epidemic levels, citing bogus research published by researchers who oppose legal abortion care.

A Texas GOP lawmaker has teamed up with an anti-choice organization to raise awareness about the supposed prevalence of forced or coerced abortion, which critics say is “wildly divorced from reality.”

Rep. Molly White (R-Belton) during a press conference at the state capitol on July 13 announced an effort to raise awareness among public officials and law enforcement that forced abortion is illegal in Texas.

White said in a statement that she is proud to work alongside The Justice Foundation (TJF), an anti-choice group, in its efforts to tell law enforcement officers about their role in intervening when a pregnant person is being forced to terminate a pregnancy. 

“Because the law against forced abortions in Texas is not well known, The Justice Foundation is offering free training to police departments and child protective service offices throughout the State on the subject of forced abortion,” White said.

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White was joined at the press conference by Allan Parker, the president of The Justice Foundation, a “Christian faith-based organization” that represents clients in lawsuits related to conservative political causes.

Parker told Rewire that by partnering with White and anti-choice crisis pregnancy centers (CPCs), TJF hopes to reach a wider audience.

“We will partner with anyone interested in stopping forced abortions,” Parker said. “That’s why we’re expanding it to police, social workers, and in the fall we’re going to do school counselors.”

White only has a few months remaining in office, after being defeated in a closely contested Republican primary election in March. She leaves office after serving one term in the state GOP-dominated legislature, but her short time there was marked by controversy.

During the Texas Muslim Capitol Day, she directed her staff to “ask representatives from the Muslim community to renounce Islamic terrorist groups and publicly announce allegiance to America and our laws.”

Heather Busby, executive director of NARAL Pro-Choice Texas, said in an email to Rewire that White’s education initiative overstates the prevalence of coerced abortion. “Molly White’s so-called ‘forced abortion’ campaign is yet another example that shows she is wildly divorced from reality,” Busby said.

There is limited data on the how often people are forced or coerced to end a pregnancy, but Parker alleges that the majority of those who have abortions may be forced or coerced.

‘Extremely common but hidden’

“I would say that they are extremely common but hidden,” Parker said. “I would would say coerced or forced abortion range from 25 percent to 60 percent. But, it’s a little hard be to accurate at this point with our data.”

Parker said that if “a very conservative 10 percent” of the about 60,000 abortions that occur per year in Texas were due to coercion, that would mean there are about 6,000 women per year in the state that are forced to have an abortion. Parker believes that percentage is much higher.

“I believe the number is closer to 50 percent, in my opinion,” Parker said. 

There were 54,902 abortions in Texas in 2014, according to recently released statistics from the Texas Department of State Health Services (DSHS). The state does not collect data on the reasons people seek abortion care. 

White and Parker referenced an oft cited study on coerced abortion pushed by the anti-choice movement.

“According to one published study, sixty-four percent of American women who had abortions felt forced or unduly pressured by someone else to have an unwanted abortion,” White said in a statement.

This statistic is found in a 2004 study about abortion and traumatic stress that was co-authored by David Reardon, Vincent Rue, and Priscilla Coleman, all of whom are among the handful of doctors and scientists whose research is often promoted by anti-choice activists.

The study was cited in a report by the Elliot Institute for Social Sciences Research, an anti-choice organization founded by Reardon. 

Other research suggests far fewer pregnant people are coerced into having an abortion.

Less than 2 percent of women surveyed in 1987 and 2004 reported that a partner or parent wanting them to abort was the most important reason they sought the abortion, according to a report by the Guttmacher Institute.

That same report found that 24 percent of women surveyed in 1987 and 14 percent surveyed in 2004 listed “husband or partner wants me to have an abortion” as one of the reasons that “contributed to their decision to have an abortion.” Eight percent in 1987 and 6 percent in 2004 listed “parents want me to have an abortion” as a contributing factor.

‘Flawed research’ and ‘misinformation’  

Busby said that White used “flawed research” to lobby for legislation aimed at preventing coerced abortions in Texas.

“Since she filed her bogus coerced abortion bill—which did not pass—last year, she has repeatedly cited flawed research and now is partnering with the Justice Foundation, an organization known to disseminate misinformation and shameful materials to crisis pregnancy centers,” Busby said.  

White sponsored or co-sponsored dozens of bills during the 2015 legislative session, including several anti-choice bills. The bills she sponsored included proposals to increase requirements for abortion clinics, restrict minors’ access to abortion care, and ban health insurance coverage of abortion services.

White also sponsored HB 1648, which would have required a law enforcement officer to notify the Department of Family and Protective Services if they received information indicating that a person has coerced, forced, or attempted to coerce a pregnant minor to have or seek abortion care.

The bill was met by skepticism by both Republican lawmakers and anti-choice activists.

State affairs committee chairman Rep. Byron Cook (R-Corsicana) told White during a committee hearing the bill needed to be revised, reported the Texas Tribune.

“This committee has passed out a number of landmark pieces of legislation in this area, and the one thing I think we’ve learned is they have to be extremely well-crafted,” Cook said. “My suggestion is that you get some real legal folks to help engage on this, so if you can keep this moving forward you can potentially have the success others have had.”

‘Very small piece of the puzzle of a much larger problem’

White testified before the state affairs committee that there is a connection between women who are victims of domestic or sexual violence and women who are coerced to have an abortion. “Pregnant women are most frequently victims of domestic violence,” White said. “Their partners often threaten violence and abuse if the woman continues her pregnancy.”

There is research that suggests a connection between coerced abortion and domestic and sexual violence.

Dr. Elizabeth Miller, associate professor of pediatrics at the University of Pittsburgh, told the American Independent that coerced abortion cannot be removed from the discussion of reproductive coercion.

“Coerced abortion is a very small piece of the puzzle of a much larger problem, which is violence against women and the impact it has on her health,” Miller said. “To focus on the minutia of coerced abortion really takes away from the really broad problem of domestic violence.”

A 2010 study co-authored by Miller surveyed about 1,300 men and found that 33 percent reported having been involved in a pregnancy that ended in abortion; 8 percent reported having at one point sought to prevent a female partner from seeking abortion care; and 4 percent reported having “sought to compel” a female partner to seek an abortion.

Another study co-authored by Miller in 2010 found that among the 1,300 young women surveyed at reproductive health clinics in Northern California, about one in five said they had experienced pregnancy coercion; 15 percent of the survey respondents said they had experienced birth control sabotage.

‘Tactic to intimidate and coerce women into not choosing to have an abortion’

TJF’s so-called Center Against Forced Abortions claims to provide legal resources to pregnant people who are being forced or coerced into terminating a pregnancy. The website includes several documents available as “resources.”

One of the documents, a letter addressed to “father of your child in the womb,” states that that “you may not force, coerce, or unduly pressure the mother of your child in the womb to have an abortion,” and that you could face “criminal charge of fetal homicide.”

The letter states that any attempt to “force, unduly pressure, or coerce” a women to have an abortion could be subject to civil and criminal charges, including prosecution under the Federal Unborn Victims of Violence Act.

The document cites the 2007 case Lawrence v. State as an example of how one could be prosecuted under Texas law.

“What anti-choice activists are doing here is really egregious,” said Jessica Mason Pieklo, Rewire’s vice president of Law and the Courts. “They are using a case where a man intentionally shot his pregnant girlfriend and was charged with murder for both her death and the death of the fetus as an example of reproductive coercion. That’s not reproductive coercion. That is extreme domestic violence.”

“To use a horrific case of domestic violence that resulted in a woman’s murder as cover for yet another anti-abortion restriction is the very definition of callousness,” Mason Pieklo added.

Among the other resources that TJF provides is a document produced by Life Dynamics, a prominent anti-choice organization based in Denton, Texas.

Parker said a patient might go to a “pregnancy resource center,” fill out the document, and staff will “send that to all the abortionists in the area that they can find out about. Often that will stop an abortion. That’s about 98 percent successful, I would say.”

Reproductive rights advocates contend that the document is intended to mislead pregnant people into believing they have signed away their legal rights to abortion care.

Abortion providers around the country who are familiar with the document said it has been used for years to deceive and intimidate patients and providers by threatening them with legal action should they go through with obtaining or providing an abortion.

Vicki Saporta, president and CEO of the National Abortion Federation, previously told Rewire that abortion providers from across the country have reported receiving the forms.

“It’s just another tactic to intimidate and coerce women into not choosing to have an abortion—tricking women into thinking they have signed this and discouraging them from going through with their initial decision and inclination,” Saporta said.

Busby said that the types of tactics used by TFJ and other anti-choice organizations are a form of coercion.

“Everyone deserves to make decisions about abortion free of coercion, including not being coerced by crisis pregnancy centers,” Busby said. “Anyone’s decision to have an abortion should be free of shame and stigma, which crisis pregnancy centers and groups like the Justice Foundation perpetuate.”

“Law enforcement would be well advised to seek their own legal advice, rather than rely on this so-called ‘training,” Busby said.